Bill > HR4527

This bill, the Health DATA Act of 2023, aims to amend the Employee Retirement Income Security Act (ERISA) to ensure that plan fiduciaries can access de-identified health claims and encounter data. The key provisions of the bill include: 1. Requiring that contracts between group health plans and providers, administrators, or pharmacy benefit managers allow plan fiduciaries to audit de-identified claims and encounter data to ensure compliance with plan terms and assess the reasonableness of compensation. 2. Prohibiting limitations on the number of audits, the amount of data that can be accessed, the disclosure of pricing terms and overpayment information, the choice of auditor, and the timeliness of access to the data. 3. Imposing civil penalties of $10,000 per day on providers, administrators, or pharmacy benefit managers who violate these requirements. 4. Voiding any contractual provisions that unduly delay or limit a plan fiduciary's access to the de-identified data. 5. Requiring annual attestations from group health plans or issuers that they are complying with the data access requirements, with exceptions for plans unable to obtain the necessary information. 6. Directing the Department of Labor to study the status of the de-identified data under ERISA and the potential regulatory or legislative actions to establish that such data belongs to the group health plan.